Why Congress must be cautious about spending more for HIT interoperability

Federal legislators should exercise caution in doling out more money for health IT interoperability efforts, as there is no guarantee that doing so will actually improve health data exchange, writes John Graham, a senior fellow at the National Center for Policy Analysis and the Independent Institute.

Graham, in a commentary for Forbes, called interoperability a "unicorn," saying that despite billions of dollars sunk into the Meaningful Use incentive program, data exchange between hospitals on disparate EHR systems remains difficult, if not impossible.

"[E]xchanging data with competitors is fundamentally against the self-interest of the part which created the data," Graham said. "Nobody would expect the U.S. Department of Transportation to set up a fund to incentivize car-makers to exchange data with each other, or the U.S. Department of Agriculture to set up a fund to incentivize grocery stores to exchange data with each other."

To bolster his point, Graham cited the lack of support expressed for the Centers for Medicare & Medicaid Services recently finalized rule for Meaningful Use flexibility. Specifically, he referenced the reaction of Russell Branzell, CEO of the College of Healthcare Information Management Executives, to a stipulation that requires 365 days of EHR reporting by providers in 2015.

Branzell and many other stakeholders had held out hope that CMS would give providers an option of reporting any three-month quarter EHR reporting period in 2015. "This sensible recommendation, if taken, would have assuaged industry concerns over the pace and trajectory of rulemaking; it would have pushed providers to meet a higher bar, without pushing them off the cliff; and it would have ensured the long-term vitality of the program itself," Branzell said. "Now, the very future of Meaningful Use is in question."

Federal advisers have expressed concern that the Office of the National Coordinator for Health IT's vision for interoperability. At the August Health IT Policy Committee meeting, committee member Paul Egerman, former CEO of eScription, said the vision might not be realistic.

"What you're trying to do here with interoperability is a very, very hard issue, especially if you define it broadly," Egerman said. "If we just get the systems themselves to talk to each other, that would be a huge accomplishment."

Graham likened ONC's interoperability plan to the Federal Highway Trust Fund, saying that it's the agency's job to "'coordinate,' not underwrite or regulate."

To learn more:
- here's Graham's post in Forbes